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目的分析低血糖昏迷误诊为急性脑血管病的病例,提供参考依据以避免误诊,延误治疗时机。方法通过对35例糖尿病低血糖昏迷患者误诊为急性脑血管病的临床资料进行回顾性分析。结果果初诊为急性脑血管病的35例患者血糖均<2.8mmol/L,符合低血糖诊断标准,均有意识障碍、肢体瘫痪、神经系统病理反射,其中老年人发病率高,60岁以上占70%,初中以下文化程度占80%。结论对老年糖尿病患者如出现疑似急性脑血管病的症状、体征应常规监测血糖,以提高低血糖的早期诊断,早期救治,减少误诊。提高对低血糖昏迷的认识,提高早期诊断率。加强对糖尿病患者的低血糖教育,用药过程中及时监测血糖,尤其对老年人及受教育能力较差的糖尿病患者,适当放宽血糖控制标准,避免出现低血糖。一旦出现低血糖昏迷,及时救治,预后较好。
Objective To analyze the cases of misdiagnosis of hypoglycemic coma as acute cerebrovascular disease and provide references to avoid misdiagnosis and delay the timing of treatment. Methods The clinical data of 35 patients with diabetes mellitus with hypoglycemic coma misdiagnosed as acute cerebrovascular disease were retrospectively analyzed. Results 35 cases of newly diagnosed acute cerebrovascular disease with blood glucose <2.8mmol / L, in line with the diagnostic criteria of hypoglycemia, are unconsciousness, limb paralysis, reflex pathological nervous system, in which the incidence of the elderly, more than 60 years of age accounted for 70 %, Below junior high school education accounted for 80%. Conclusion For elderly patients with diabetes mellitus, symptoms and signs of suspected acute cerebrovascular disease should be monitored regularly to improve the early diagnosis, early treatment and reduce the misdiagnosis of hypoglycemia. Improve awareness of hypoglycemic coma and improve early diagnosis. To strengthen the education of hypoglycemia in diabetic patients, timely monitoring of blood sugar during medication, especially for the elderly and poor education of diabetic patients, the appropriate relaxation of blood glucose control standards to avoid hypoglycemia. Once the hypoglycemic coma, timely treatment, the prognosis is good.